Glucose-6-phosphate dehydrogenase deficiency and long-term risk of immune-related disorders

Frontiers in Immunology

Immunology

Alejandro A. Schäffer¹  Eytan Ruppin¹  Eugene Merzon²  David J. Ozeri³  Eli Magen⁴  Ariel Israel⁵  Ilan Green⁵  Avivit Golan-Cohen⁵  Shlomo Vinker⁵  Matitiahu Berkovitch⁶ 

[1] Cancer Data Science Laboratory, National Cancer Institute, Bethesda, MD, United States;Leumit Research Institute, Leumit Health Services, Tel Aviv-Yafo, Israel;Adelson School of Medicine, Ariel University, Ariel, Israel;Leumit Research Institute, Leumit Health Services, Tel Aviv-Yafo, Israel;Division of Rheumatology, Sheba Medical Center, Ramat Gan, Israel;Leumit Research Institute, Leumit Health Services, Tel Aviv-Yafo, Israel;Medicine A Department, Assuta Ashdod University Hospital Faculty of Health Sciences, Ben-Gurion University, Beer-Sheba, Israel;Leumit Research Institute, Leumit Health Services, Tel Aviv-Yafo, Israel;School of Public Health and Family Medicine Department, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel;School of Public Health and Family Medicine Department, Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel;Clinical Pharmacology and Toxicology Unit, Shamir Medical Center, Zerifin, Israel;

关键词: G6PD deficiency;    autoimmunity;    allergy;    infectious diseases;    fibromyalgia;    hidradenitis suppurativa;    rheumatoid arthritis;    lupus (SLE);   

DOI  :  10.3389/fimmu.2023.1232560

 received in 2023-05-31, accepted in 2023-08-29,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionGlucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked enzymatic disorder that is particularly prevalent in Africa, Asia, and the Middle East. This study aimed to assess the long-term health risks associated with G6PD deficiency.MethodsA retrospective cohort study was conducted using data from a national healthcare provider in Israel (Leumit Health Services). A total of 7,473 G6PD-deficient individuals were matched with 29,892 control subjects in a 1:4 ratio, based on age, gender, socioeconomic status, and ethnic groups. The exposure of interest was recorded G6PD diagnosis or positive G6PD diagnostic test. The main outcomes and measures included rates of infectious diseases, allergic conditions, and autoimmune disorders between 2002 and 2022.ResultsSignificantly increased rates were observed for autoimmune disorders, infectious diseases, and allergic conditions in G6PD-deficient individuals compared to the control group. Specifically, notable increases were observed for rheumatoid arthritis (odds ratio [OR] 2.41, p<0.001), systemic lupus erythematosus (OR 4.56, p<0.001), scleroderma (OR 6.87, p<0.001), pernicious anemia (OR 18.70, p<0.001), fibromyalgia (OR 1.98, p<0.001), Graves’ disease (OR 1.46, p=0.001), and Hashimoto’s thyroiditis (OR 1.26, p=0.001). These findings were supported by elevated rates of positive autoimmune serology and higher utilization of medications commonly used to treat autoimmune conditions in the G6PD-deficient group.DiscussionIn conclusion, individuals with G6PD deficiency are at a higher risk of developing autoimmune disorders, infectious diseases, and allergic conditions. This large-scale observational study provides valuable insights into the comprehensive association between G6PD deficiency and infectious and immune-related diseases. The findings emphasize the importance of considering G6PD deficiency as a potential risk factor in clinical practice and further research is warranted to better understand the underlying mechanisms of these associations.

【 授权许可】

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Copyright © 2023 Israel, Schäffer, Berkovitch, Ozeri, Merzon, Green, Golan-Cohen, Ruppin, Vinker and Magen